What do GP access targets mean for care quality and staff wellbeing?

The new GP contract outlines new requirements for patient access, and the latest IIF incentive scheme makes certain funding contingent on meeting access targets. They’ve caused some anxiety among practices, who are already flat-out trying to meet the demand for GP appointments, and who are in many cases seriously understaffed. 

What does the contract really say, how can practices make sure they’re meeting the new targets without burning out their staff, and could an obsession with patient access undermine the patient experience and healthcare practitioners’ wellbeing? 

How can GPs meet the new access requirements? 

The latest GP contract forbids practices from asking patients to call back at another time. When a patient contacts the surgery, the available options for the practice are to: 

  • offer an appointment 
  • offer treatment advice 
  • signpost the patient to appropriate other services, such as 111 
  • ask the patient for more information, or communicate a timeline for receiving treatment or support options. 

The contract doesn’t insist that surgeries book an appointment for every patient as and when they call. It doesn’t define access strictly as an appointment — there are several ways that a patient is counted as having ‘accessed’ primary care. 

  • A holding response is still a response. It’s perfectly acceptable to acknowledge the patient and estimate a timeline for consultation or treatment. 
  • You may direct patients elsewhere where appropriate. For example, surgeries will be able to signpost patients to pharmacies for certain conditions. 
  • Remote appointments are an option. Many patients will be happy with a phone or video consultation. They are more time-efficient than an in-person appointment. 

There’s good news for practices in that meeting the contract’s access expectations is not as daunting as it may seem. The troubling side of that coin is that it doesn’t show any practical commitment to improving patient access. It simply broadens the definition of access. 

In the absence of substantial support that will help GPs see more patients, either 

  1. the requirements are purely symbolic 
  2. the contract implies that you can improve patient access simply by demanding it 

The practical support that primary care networks will get may well create more problems than it solves. Here’s why. 

Why IIF access incentives will do more harm than good 

Primary Care Networks will get an average of £11,500 per month to improve patient access. In March 2023, NHS England announced that a further c.£60,000 would be available to PCNs who developed access plans to deliver appointments to 85% of patients within two weeks of a request. 

A results-based target makes the subtle but insulting implication that if GPs aren’t seeing enough patients, then the issue is motivation, and that money is what will motivate them.  

However, leaving aside the diplomacy of the issue, extra funding could help, but GPCE negotiators for the BMA advise that what is on offer is not sufficient for the amount of work it would take to win. They warn that the typical number of appointments that it would take to earn it would endanger patients and staff. 

Dr. Claire Bannon: ‘…practices need to think about if that’s not doable, then consider not doing it. We’ve been talking to LMCs a lot about safe working and you need to think about 25 contacts a day. If you’re seeing more than 25 patients a day then is that manageable? Is that going to be safe? Are you going to risk burning out?’ 

What’s the real route to better patient access? 

Any patient access plan needs to address the fundamental issue — the shortage of GPs. 

Admittedly, that’s a vast political and medical undertaking, but it’s the only one that will have a meaningful impact on primary care. 

MCG Healthcare will continue to champion the wellbeing of primary care professionals and the practices they work in. For our part, we only match GPs and primary care nurses to surgeries where we know they will thrive. If any of our GPs worry that they might be suffering from burnout, our GP Wellbeing Lead, Dr. Matt Mayer, is available to support them. 

To find the ideal next role, or the perfect healthcare professional for your practice, call 0330 024 1345 or email hello@mcghealthcare.co.uk.  

About the author
Ash Higgs Managing Director

Ash Higgs is the Managing Director of MCG Healthcare. He has a long-demonstrated history working in recruitment and has now been involved in the medical industry for over 5 years. During this time, he has gained a strong understanding of the issues that both Primary & Secondary Care are facing regarding the recruitment of healthcare professionals.

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